Full-Time

Professional Services Manager

HEDIS and Risk Adjustment

Posted on 11/20/2024

Inovalon

Inovalon

1,001-5,000 employees

Cloud-based healthcare data analytics solutions

Consulting
Healthcare

Compensation Overview

$71.8k - $110kAnnually

+ Performance-based incentives

Senior

Remote in USA

Remote work is available 100% of the time with up to 10% travel.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
SQL
Tableau
Data Analysis
Snowflake
Requirements
  • Minimum of 5 years of health plan Quality, CMS STARS or Risk Adjustment program delivery experience
  • Minimum of 3 years’ experience working in customer-facing roles, either internal or external, with strong interaction, consultative skills and ownership for developing and deepening relationships, driving customer satisfaction and issue management
  • Previous experience working in professional services or consulting, preferably with a focus on payer customers preferred
  • Ability to identify customer needs in complex regulatory environments and successfully execute on solution delivery, issue resolution, retention, adoption and expansion strategies
  • Excellent communication and presentation skills; with the ability to adapt communication style depending on audience (customers / internal partners / Leadership)
  • Deep knowledge of health care data, billing practices and reimbursement models;
  • Takes a proactive approach towards executing on numerous tasks and priorities simultaneously while also managing client relationships and expectations;
  • Detail-oriented and the ability to work in a fast-paced environment;
  • Tableau, SnowFlake and/or SQL experience a plus;
  • Knowledge of and familiarity with Microsoft Office tools, including Access, Excel, Word, and Outlook;
  • Previous experience with Inovalon tools a plus.
  • Bachelor's degree is required (degree in health care, information systems, computer science, statistics, analytics or a related field of study is preferred).
Responsibilities
  • Comprehensively manage concurrent customer Professional Service engagements across the company’s Payer product portfolio
  • Act as client-facing point of contact for all Quality/STARS/Risk related activities within assigned client engagements
  • Act as trusted advisor to customers to understand their Quality and/or Risk Adjustment program goals, business drivers and help design, execute and monitor Professional Services to support customer outcomes
  • Actively manage outstanding issues and drive issues to resolution while effectively managing client expectations
  • Develop and maintain an industry and regulatory expertise from a Quality and Risk Adjustment perspective; author and advise the creation of industry thought capital
  • Identify (and close) growth opportunities based on client needs, and partner with sales, implementation and customer success teams to ensure positive customer experience
  • Establish a strong leadership shadow that reinforces the Inovalon values
  • Demonstrate effective and clear written and verbal communication skills, specifically the ability to speak to technical customers, including the drafting of high-quality, written documentation and presentations for internal and external communications
  • Deploy strong analytical and organization skills; have an ability to work independently and proactively, be accepting of ambiguity in a fast-paced environment
  • Maintain compliance with Inovalon’s policies, procedures and mission statement
  • Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position
  • Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company
  • Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.

Inovalon provides cloud-based software solutions that focus on improving data-driven healthcare. The company offers a platform that integrates real-time data access and advanced analytics, supporting over 100 solutions for healthcare organizations. These solutions help clients enhance patient care, streamline operations, and improve financial performance. Inovalon's platform is designed to be user-friendly and integrates easily with existing healthcare systems, allowing clients to access tools for revenue cycle management, care quality management, and workforce management. Unlike many competitors, Inovalon emphasizes national-scale connectivity and automated processing, making it easier for healthcare providers, payers, and pharmaceutical companies to utilize their data effectively. The goal of Inovalon is to empower healthcare organizations to achieve better clinical outcomes and operational efficiencies through the effective use of data.

Company Stage

IPO

Total Funding

N/A

Headquarters

Bowie, Maryland

Founded

1997

Growth & Insights
Headcount

6 month growth

1%

1 year growth

45%

2 year growth

45%
Simplify Jobs

Simplify's Take

What believers are saying

  • Partnership with MEDITECH enhances market reach and client base.
  • AI-powered Converged Record Review improves risk score accuracy for health plans.
  • Top vendor recognition boosts brand reputation and attracts new clients.

What critics are saying

  • $50M fraud lawsuit could damage Inovalon's financial and reputational standing.
  • Integration issues with MEDITECH may cause delays in revenue cycle management.
  • Subscription-based revenue model vulnerable to healthcare budget constraints.

What makes Inovalon unique

  • Inovalon integrates advanced cloud-based analytics for improved healthcare outcomes.
  • The company offers over 100 solutions for healthcare operations optimization.
  • Inovalon's platform supports real-time data exchange and electronic decision support.

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